Nursing Elites

1. Two people experience the same stressor yet only one is able to cope and adapt adequately. An example of the person with an increased capacity to adapt is the one with:

• A. A sense of purpose in life
• B. Circadian rhythm disruption
• C. Age-related renal dysfunction
• D. Excessive weight gain or loss

Correct answer: A

Rationale: A strong sense of purpose in life is associated with better stress coping mechanisms, which can enhance a person's capacity to adapt. Having a clear sense of purpose provides individuals with motivation, direction, and resilience to face challenges. Choices B, C, and D are not directly related to an increased capacity to adapt to stress. Circadian rhythm disruption, age-related renal dysfunction, and excessive weight gain or loss may have negative impacts on overall well-being and stress management.

2. A 45-year-old diabetic male is experiencing erectile dysfunction. If his erectile dysfunction is caused by the nervous system, then the nurse can educate the client that the venous blood supply to the penis is controlled by:

• A. Sympathetic nerves.
• B. Parasympathetic nerves.
• C. Somatic nerves.
• D. Spinal reflexes.

Correct answer: B

Rationale: Erectile function is primarily controlled by the parasympathetic nervous system, which facilitates the dilation of blood vessels in the penis. The parasympathetic nerves are responsible for vasodilation in the penis, allowing blood to enter and creating an erection. Sympathetic nerves, on the other hand, are responsible for ejaculation by causing contraction of the muscles around the vas deferens. Somatic nerves are involved in sensation and movement, not specifically in controlling blood supply to the penis. Spinal reflexes can play a role in the erectile process, but they are not directly responsible for controlling the venous blood supply.

3. In a 41-year-old male patient with a complex medical history diagnosed with secondary hypogonadism, which of the following health problems is the most likely etiology of his diagnosis?

• A. Type 1 diabetes
• B. Mumps
• C. An inflammatory process in the testicles
• D. Testicular trauma

Correct answer: C

Rationale: The correct answer is C: An inflammatory process in the testicles. Secondary hypogonadism in males can be caused by various factors, including an inflammatory process in the testicles. Mumps (choice B) can lead to orchitis but is less common in adults. Type 1 diabetes (choice A) is not a common cause of secondary hypogonadism. Testicular trauma (choice D) can cause primary hypogonadism but is less likely to cause secondary hypogonadism.

4. A patient has been prescribed raloxifene (Evista) for the prevention of osteoporosis. What effect should the nurse include in the teaching plan regarding the action of this medication?

• A. Decreases calcium excretion by the kidneys.
• B. Increases intestinal absorption of calcium.
• C. Stimulates bone formation by increasing osteoblast activity.
• D. Selectively binds to estrogen receptors, decreasing bone resorption.

Correct answer: D

Rationale: The correct answer is D: Selectively binds to estrogen receptors, decreasing bone resorption. Raloxifene is a selective estrogen receptor modulator (SERM) that works by binding to estrogen receptors, thereby decreasing bone resorption. This action helps in the prevention and treatment of osteoporosis by preserving bone density. Choices A, B, and C are incorrect because raloxifene does not directly affect calcium excretion by the kidneys, intestinal absorption of calcium, or stimulate bone formation by increasing osteoblast activity.

5. A patient is prescribed medroxyprogesterone acetate (Provera) for endometriosis. What should the nurse teach the patient about the proper use of this medication?

• A. Take the medication at the same time each day to maintain consistent hormone levels.
• B. Avoid prolonged sun exposure while taking this medication.
• C. Discontinue the medication if side effects occur.
• D. Apply the medication once a week.

Correct answer: A

Rationale: The correct answer is to take the medication at the same time each day to maintain consistent hormone levels and effectiveness. Consistency in timing helps regulate the hormone levels in the body, ensuring the medication's optimal benefit. Choice B is incorrect as there is no specific need to avoid sun exposure with this medication. Choice C is incorrect because discontinuing the medication without consulting the healthcare provider may not be safe. Choice D is incorrect as medroxyprogesterone acetate is typically taken orally and not applied topically once a week.

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